Sr. Executive Director of Operations

Overview

This position is responsible for the oversight of operations and executive management of theClaims, Configuration, Network Services and Credentialing departments within PartnershipHealthPlan of California (Partnership). This position provides leadership in organizing theHealthPlan’s operations and interdepartmental communication, and participates in goal settingand strategic organizational planning.

Responsibilities

▪ Daily oversight of the assigned operational departments.▪ Works with department directors to establish department goals, improve operationaleffectiveness, and implement work plans, making corrective actions as needed.▪ Monitors and evaluates performance of direct reports and ensures standardized reportingamong operational departments, including the timely completion of Executive and Boardlevel dashboards.▪ Identifies opportunities to improve operational efficiencies and helps facilitatecommunication between HealthPlan departments to meet business challenges.▪ Provides leadership in interdepartmental projects involving department operations toensure quality outcomes.▪ Participates in new business planning and program development.▪ Monitors expenses and justifies variances from approved budgets.▪ Develops and maintains analytic reports and performance metrics related to strategicgoals and projects.▪ Communicates Partnership operational performances and capabilities, with dutiesincluded but not limited to, development of reports and information for regulators, staff,and Board.▪ Supports Operational Excellence principles and initiatives to ensure performanceimprovement.▪ Supports department leaders in successfully meeting the requirements and standards ofNCQA, DHCS, or other regulatory bodies.▪ Supports direct reports in providing excellent and responsive service to our members andother stakeholders.▪ Oversees payment systems projects and implementation.

Secondary Duties and Responsibilities▪ Leads, assigns, and participates in special projects as needed.

Qualifications

Education And Experience

Master’s degree in Business, Public Health, Health Administration,Communication, Marketing, Government, Political Science, or relatedfield; minimum five (5) years management experience with a healthcare organization (managed care or prepaid health system experiencepreferred); general and fiscal operations; or equivalent combination ofeducation and experience.

Special Skills, Licenses and Certifications

Comprehensive knowledge of California’s Medi-Cal Program. Strongcustomer service orientation; ability to build and maintain positiveworking relationships; ability to exercise good judgement in decisionmaking. Valid California driver’s license and proof of currentautomobile insurance compliant with Partnership policy are required tooperate a vehicle and travel for company business.

Performance Based Competencies

Excellent written and oral communication skills. Excellentinterpersonal skills to develop and maintain critical relationships withexternal sources. Ability to handle varying situations with tact anddiplomacy.

Work Environment And Physical Demands

Ability to use a computer keyboard. More than 15% of total work timeis spent in front of a computer monitor. When required, must be able tomove, lift, or carry objects of varying size, weighing up to 35 lbs. Mustbe able to operate a vehicle used for company business. Extensivetravel may be required.

Hiring Range:

$259,563.60 - $363,389.03

All HealthPlan employees are expected to:▪ Provide the highest possible level of service to clients;▪ Promote teamwork and cooperative effort among employees;▪ Maintain safe practices; and▪ Abide by the HealthPlan’s policies and procedures, as they may from time to time beupdated.

IMPORTANT DISCLAIMER NOTICEThe job duties, elements, responsibilities, skills, functions, experience, educational factors andthe requirements and conditions listed in this job description are representative only and notexhaustive or definitive of the tasks that an employee may be required to perform. The employerreserves the right to revise this job description at any time and to require employees to performother tasks as circumstances or conditions of its business, competitive considerations, or workenvironment change.